The Ministry of Health has started distributing nine high-tech medications intended for cancer treatment within the Brazilian public network. This initiative is part of a governmental plan focused on expanding access to oncological therapies in the country.
The drugs cover 13 clinical indications, covering treatments for high-incidence cancers such as breast, prostate, and lung cancer, as well as lymphomas. Initially, it is expected to benefit more than 116 thousand patients across 20 health units located in 17 states, with the goal of covering the entire public network by the end of the year.
Maria Ignez Braghiroli, an oncologist specializing in gastrointestinal tract tumors at Oncologia D’Or and a member of the Gastrointestinal Tumor Group at the State Cancer Institute of São Paulo (Icesp), detailed the impact of including these new medications in the Unified Health System (SUS), their applications, and the necessary care during treatment.
Among the introduced medications are abemaciclibe, used in breast cancer treatment, and pazopanib, indicated for advanced stages of kidney cancer. These therapies offer more treatment options but require rigorous medical monitoring and specific care.
According to Maria Ignez, abemaciclibe works by inhibiting proteins that stimulate tumor cell proliferation. It is used in a type of breast cancer that is hormone receptor positive. The treatment is often combined with hormonal therapy and, because it is oral, allows the patient to administer it at home, following prescribed times and doses, usually twice a day.
The oncologist warned that the most common side effect is diarrhea, especially in the first weeks, requiring constant monitoring. Additionally, it can cause fatigue and nausea in some individuals.
Regarding pazopanib, Maria Ignez clarified that it interferes with processes that promote tumor growth and the formation of blood vessels that nourish cancerous cells. It is an anti-angiogenic targeted therapy, released by the SUS for renal cell cancer, because it blocks signals that drive tumor growth and vascularization, restricting nutrient supply.
The use of pazopanib requires continuous vigilance, especially due to possible changes in blood pressure and liver function. Hypertension can occur even in patients without prior history, and liver changes must be checked through periodic blood tests. The doctor added that despite the increased risk of bleeding, the general tolerance of the drug is reasonable when compared to traditional chemotherapy.
Another novelty is the inclusion of trastuzumab, already used in certain breast tumors, to treat specific cases of stomach and gastroesophageal junction cancer. This indication is linked to the presence of the HER2 protein, whose amplification occurs in a percentage of gastric tumors.
Braghiroli explained that the efficacy of trastuzumab in this new context was investigated in studies over ten years ago. Initially, the drug was used in breast tumors with HER2 amplification, and a 2010 study demonstrated its benefit in treating gastric tumors with this molecular characteristic. Since then, it has been approved in combination with chemotherapy for specific tumors.
Research continues to advance, with recent studies, such as one from 2023, showing the benefit of combining immunotherapy with this combination. The doctor emphasized that for the SUS, this is a significant advance, given that this medication has proven efficacy for some time.
The list provided by the Ministry of Health includes treatments for various types of cancer, whose indications depend on the characteristics and stage of the disease. Abiraterone, for example, acts on hormonal stimulation, a key mechanism in prostate cancer progression. By reducing testosterone production, it helps control the disease, even in areas where conventional hormonal treatments were not fully effective.
According to the specialist, abiraterone is used when standard hormonal blockade methods fail, being a well-established treatment in clinical practice. However, not all treatments are universal; the indication for some depends on detecting specific genetic or protein alterations in the tumor cells, making laboratory tests crucial for therapeutic decisions.
Gefitinib, used against certain lung tumors, is an example of this. Although it is an established treatment, it is only indicated if the tumor presents a mutation in the EGFR gene, conferring sensitivity to the therapy. This alteration is confirmed by a molecular test performed on a tumor sample collected during diagnosis.
In addition to the provision of medications, the Ministry of Health has begun distributing 400 thousand fecal immunochemical tests to Brazilian states and capitals. This action aims to intensify the prevention and early diagnosis of intestinal cancer, targeting men and women between 50 and 75 years old.
The test detects traces of blood in the feces, even those invisible to the naked eye, which may indicate existing polyps or tumors. Early identification allows referral for complementary exams, such as colonoscopy, which allows visualization of the intestine and removal of polyps. Several medical societies recommend this preventive screening.
The fecal immunochemical test serves as the first phase of this investigation: a positive result directs the individual to colonoscopy to determine the source of the bleeding and evaluate lesions. Other improvements in the public network include the implementation of cervical cancer screening with DNA tests and federal funding for video-thoracic oncological surgeries, which allow for faster recovery.
Despite the expansion of these initiatives, the main challenge for the SUS remains ensuring that the availability of medications, exams, and procedures translates into effective care, guaranteeing complete patient follow-up throughout the entire treatment process.